Active NPI
Blayne Manning
- Adult Health Nurse Practitioner
- Great Neck, NY
National Provider Identifier
1013461276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 307828
- Practice address
- 225 Community Dr
#110
Great Neck, NY 11021-5503 - Phone
- (516) 918-4388
- NPI assigned
- Aug 5, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 307828 | NY | Primary |
Addresses
Primary practice location
225 Community Dr
#110
Great Neck, NY 11021-5503
Mailing address
225 Community Dr
#110
Great Neck, NY 11021-5503
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 307828 | NY | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470355200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470355200000",
"number": "1013461276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 COMMUNITY DR",
"address_2": "#110",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110215503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 COMMUNITY DR",
"address_2": "#110",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110215503",
"telephone_number": "516-918-4388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNING",
"first_name": "BLAYNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-05",
"last_updated": "2016-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "NY",
"license": "307828",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.